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ludc webb

Nuno Dias

Associate professor

ludc webb

Techniques for aortic arch endovascular repair.

Author

  • Kiattisak Hongku
  • Nuno Dias
  • Björn Sonesson
  • Tim Resch

Summary, in English

This article reviews endovascular strategies for aortic arch repair. Open repair remains the gold standard particularly for good risk patients. Endovascular treatment potentially offers a less invasive repair. Principles, technical considerations, devices and outcomes of each technique are discussed and summarized. Hybrid repair combines less invasive revascularization options, instead of arch replacement while extending stent graft into the arch. Outcomes vary with regard to extent of repair and aortic arch pathologies treated. Results of arch chimney and other parallel graft techniques perhaps make it a less preferable choice for elective cases. However, they are very appealing options for urgent or bailout situations. Fenestrated stent grafting is subjected to many technical challenges in aortic arch due to difficulties in stent graft orientation and fenestration positioning. In situ fenestration techniques emerge to avoid these problems, but durability of stent grafts after fenestration and ischemic consequences of temporary carotid arteries coverage raises some concern total arch repair using this technique. Arch branched graft is a new technology. Early outcomes did not meet the expectation; however the results have been improving after its learning curve period. Refining stent graft technologies and implantation techniques positively impact outcomes of endovascular approaches.

Department/s

  • Vascular Diseases - Clinical Research

Publishing year

2016-03-04

Language

English

Pages

421-436

Publication/Series

Journal of Cardiovascular Surgery

Volume

57

Issue

3

Document type

Journal article review

Publisher

Edizioni Minerva Medica

Topic

  • Cardiac and Cardiovascular Systems
  • Surgery

Status

Published

Research group

  • Vascular Diseases - Clinical Research

ISBN/ISSN/Other

  • ISSN: 0021-9509